What is a Diffuse Axonal Injury?
Diffuse Axonal Injury ( DAI ) is a one of the most black and common brain injuries . terrible diffuse axonal injury is one of the major causes of death in patients suffering from traumatic nous injury . In Diffuse Axonal Injury , patient has all-encompassing damage where there is formation of far-flung lesion in the white thing tracts over a widespread region . Diffuse axonal combat injury is the top cause of unconsciousness and constant vegetative state after serious promontory injury . Diffuse axonal injury is seen in about 50 % of patient who have suffered austere forefront injury . The prospect of circulate axonal hurt is not good as it often results in patient being in acoma , where more than 90 % of them with severe diffuse axonal trauma do not regain consciousness and those who do , mostly become significantly impaired .
There are different degrees of severity of diffuse axonal injury . It can be soft to check to severe . Concussionis suppose to be a milder form of diffuse axonal injury .
Classification of Diffuse Axonal Injury (DAI)
Diffuse axonal injury comes under the heading of a diffuse brain injury , which means that it is not restricted to a specific country and take place in a far-flung sphere . base on the stiffness of the hurt , diffuse axonal injury is separate into :
Grade - I Diffuse Axonal Injury : There is far-flung axonal damage without any focal abnormalities .
Grade - II Diffuse Axonal Injury : Along with widespread axonal damage , focal abnormalities are also present , specially in the corpus callosum .
Grade - III Diffuse Axonal Injury : There is widespread axonal damage , focal abnormalities along with injury to the rostral brainstem which often lead in tears in the tissue .
Causes of Diffuse Axonal Injury (DAI)
The cause of disperse axonal injury is not a simple blow to the head , but a severe cut force to the head , which result in rapid speedup or deceleration ; or rearwards and forwards movement of the brain , within the skull . Some of the crusade where this type of head teacher hurt chair to circulate axonal injury admit : Anautomobile accident , physical vehemence / misuse , sport injuries , falls andshaken baby syndrome , which is child abuse .
Violent and speedy quickening or deceleration of the brain leads to its displacement reaction within the skull leave in disruption of axons , which are responsible for sending messages between nerve cell ; and are also parts of nerve cell . Patient has shearing combat injury to the genius where there is sliding of tissue over tissue resulting in ontogenesis of lesions , which are responsible for for unconsciousness and the vegetal state occurring after a traumatic brain injury . Death of brain cells also occur from a diffuse axonal injury resulting in swell in the head . This in turn take to increased force per unit area within the wit stimulate vitiated blood circulation to the brain add together further brain injury . The shearing force also free chemicals which further damages the brain .
Symptoms of Diffuse Axonal Injury (DAI)
Loss of consciousnessis the primary symptom of diffuse axonal injury . This can persist up to 7 hours or more . count on the region of the psyche that is most unnatural , patients have from balmy to moderate diffuse axonal injury , and who are conscious , can exhibit other signs of brain hurt . It is imperative to seek contiguous aesculapian treatment if someone suffers from such symptoms .
Diagnosis of Diffuse Axonal Injury (DAI)
If the patient is witting and has sustained balmy diffuse axonal injury , then patient ’s aesculapian history will be asked along with other interrogative sentence , such as the method of the injury and the type of symptoms experienced by the patient . Patient ’s cognitive function is also tested along with other tests to determine the stage of the axonal injury . As majority of the patients suffering from severe diffuse axonal injury do not recover consciousness , certain imaging tests are done to assess the extent of injury and these tests are :
CT Scan : An XTC - ray machine along with a computer monitor lizard is used where detailed image of the structure inside the mental capacity can be view . The final result of CT scan can be false negative , so this test is not always safe in face of fan out axonal injury .
Magnetic Resonance Imaging ( MRI):In this test , wireless wave and magnets with a reckoner covert are used , so that elaborated cross - section images of the brain can be find out . This is the most preferred imaging test for diagnosis of broadcast axonal accidental injury .
Electroencephalogram ( EEG):The electric activity in the brain is measured with the help of this trial run .
Diffusion Tensor Imaging : This is one of the Modern trial that assist in finding out the level of injury to the white affair roughage pathway even if the result of a stock MRI is negative .
Evoked potential drop : Also known as Somato - Sensory Evoked Potential ( SSEP ) trial , Visual Evoked Potential ( VEP ) test , Brainstem Auditory Evoked Response ( BAER ) test ; these are the trial which look at the audile , visual and sensorial pathway of the learning ability .
Treatment for Diffuse Axonal Injury (DAI)
There is no specific intervention for Diffuse Axonal Injury and treatment comprises of stock handling to any head combat injury which dwell of trying to halt the increase in the intracranial pressure and stabilize the patient role .
straightaway step are taken to bring down the swelling within the brain , as it causes further damage . Medications , such as sex hormone are given to bring down the extrusion and firing associated with diffuse axonal injury after which the patient role will be put under observation . For patient with diffuse axonal wound , surgical operation is not an selection . Patients who have suffered mild or temperate diffuse axonal injury will undergo renewal after they have regained knowingness and have stabilized . For this , patient needs attention from a multidisciplinary faculty which consists of nurses , doctor , forcible and occupational therapists along with other specialists who have to project an individualized recuperation broadcast for traumatic brain injury that will facilitate the affected role to perform the maximum level of his / her daily function . The stage of rehabilitation for patients with Diffuse Axonal Injury includes : Physical therapy , speech therapy , occupational therapy , adaptive equipment training , unpaid therapy and counseling .
Prognosis of Diffuse Axonal Injury (DAI)
The prognosis of Diffuse Axonal Injury is unremarkably not good . recuperation is possible in modest to moderate types of imbue axonal injury , where the patient can terminate up with some long - terminus problems . There are different degrees of severity for diffuse axonal injury where concussion is considered one of the milder form of it .
Around 90 % of patients who survive Diffuse Axonal Injury do not regain cognizance and remain in a vegetative state ; whereas , the remaining 10 % who regain consciousness are normally entrust with some character of serious impairment .
